Review shivering and nonshivering thermogenesis

Shivering is the spontaneous, asynchronous, random contraction of skeletal muscles in an effort to increase the basal metabolic rate. Shivering is modulated through the hypothalamus and can increase the body's production of heat by up to 300% in young, muscular individuals. It increases oxygen consumption and carbon dioxide production. This effect may be undesirable in the patient with coronary artery disease or pulmonary insufficiency.

Infants younger than 3 months of age cannot shiver and mount a caloric response by nonshivering thermogenesis, which increases metabolic heat production without producing mechanical work. Skeletal muscle and brown fat tissue are the major energy sources for this process.

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